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首页> 外文期刊>The American Journal of Cardiology >Comparison of Causes and Associated Costs of 30-Day Readmission of Transcatheter Implantation Versus Surgical Aortic Valve Replacement in the United States (A National Readmission Database Study)
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Comparison of Causes and Associated Costs of 30-Day Readmission of Transcatheter Implantation Versus Surgical Aortic Valve Replacement in the United States (A National Readmission Database Study)

机译：经导沟管植入的30天植入性与外科主动脉瓣膜更换的原因和相关成本的比较（国家入院数据库研究）

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Our current knowledge about comparative differences in 30-day readmissions and the impact of readmissions on overall costs after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) is largely derived from clinical trials. The objectives of this study were to compare readmissions and costs for TAVI and SAVR in a nationally representative population-based sample. The Healthcare Cost and Utilization Project's National Readmission Database was used for the study. Hierarchical multivariable regression analyses were used to examine differences in the propensity score 1:1 matched cohort. The matched cohort included 4,682 patients who survived index procedures done from January through November 2013. Compared with SAVR, the rate of 30-day readmission was not significantly different for endovascular TAVI (16% vs 18%; p?=?0.19); and was higher for the transapical TAVI (22% vs 17%; p <0.01) group. The 30-day cumulative costs were higher for the 2 endovascular TAVI ($51,025 vs $46,228; p = 0.03) and transapical TAVI ($59,575 vs $45,792; p <0.01). In multivariable analyses, the risk of 30-day readmission was similar for endovascular TAVI (odds ratio [OR] 0.93; 95% confidence interval [CI] 0.78 to 1.12) and was 27% higher for transapical TAVI (OR 1.27; 95% CI 1.02 to 1.57). Cumulative costs (index plus readmission costs) were 13% (β 0.13; 95% CI 0.10 to 0.15) and 19% (β 0.19; 95% CI 0.16 to 0.23) higher for the endovascular TAVI and transapical TAVI, respectively. In conclusion, the rate of readmissions was similar for endovascular TAVI and SAVR but the costs were 26% higher for TAVI than for SAVR.
机译：我们目前关于30天内入院比较差异的知识以及转膜主动脉瓣膜植入（TAVI）和手术主动脉瓣膜置换（SAVR）的总体成本对整体成本的影响主要来自临床试验。本研究的目标是在全国代表性人口的样本中比较Tavi和Savr的阅法和成本。医疗费用和利用项目的国家入院数据库用于该研究。分层多变量回归分析用于检查倾向分数1：1匹配的队列的差异。匹配的队列包括4,682名患者幸存下来的指数程序，从1月至2013年1月完成。与萨维尔相比，30天的阅览对于血管内Tavi没有显着差异（16％vs 18％; p？= 0.19）; TAVAPICAL TAVI（22％vs 17％; P <0.01）组较高。对于2个血管内Tavi来说，30天的累积成本较高（51,025美元，46,228美元; P = 0.03）和Tappapical Tavi（59,575美元VS 45,792; P <0.01）。在多变量的分析中，30天即将入院的风险类似于血管内TaVi（差距[或] 0.93; 95％置信区间[Ci] 0.78至1.12），用于转产Tavi（或1.27; 95％CI）的27％更高1.02至1.57）。对于血管内TaVi和Tavepapical Tavi，累积成本（β013; 95％CI 0.10至0.15）和19％（β0.19; 95％CI 0.16至0.23）。总之，Readmissions的率类似于血管内Tavi和Savr，但Tavi的成本比Savr更高26％。

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